Efficacy

Lonsurf (trifluridine/tipiracil) Efficacy in Colorectal Cancer

Lonsurf, a combination of trifluridine and tipiracil, is an oral chemotherapy medication approved for the treatment of patients with metastatic colorectal cancer (mCRC) who have been previously treated with chemotherapy and biologic therapy. Clinical trials have demonstrated that Lonsurf can extend overall survival in this patient population. The pivotal phase III trial, known as the RECOURSE study, showed that patients treated with Lonsurf had a median overall survival of 7.1 months compared to 5.3 months for those receiving placebo. This indicates a significant improvement in survival for patients with refractory mCRC.

The efficacy of Lonsurf is attributed to its two active components: trifluridine, which is incorporated into DNA and inhibits cell proliferation, and tipiracil, which increases the bioavailability of trifluridine by inhibiting its degradation. The combination of these two agents contributes to the antitumor activity observed in the treatment of colorectal cancer. However, it is important to note that the benefits of Lonsurf must be weighed against its potential side effects, which can include neutropenia, nausea, fatigue, and anemia, among others.

Cyramza (ramucirumab) Efficacy in Colorectal Cancer

Cyramza, known generically as ramucirumab, is a monoclonal antibody that targets the vascular endothelial growth factor receptor 2 (VEGFR2). It is approved for use in combination with FOLFIRI (folinic acid, fluorouracil, and irinotecan) for the treatment of patients with metastatic colorectal cancer who have progressed on a first-line bevacizumab, oxaliplatin, and a fluoropyrimidine-containing regimen. The approval was based on the results of the RAISE trial, which demonstrated that patients receiving Cyramza in combination with FOLFIRI had a median overall survival of 13.3 months compared to 11.7 months for patients receiving placebo plus FOLFIRI.

Cyramza works by inhibiting angiogenesis, the formation of new blood vessels that tumors need to grow and spread. By blocking VEGFR2, Cyramza can slow the progression of metastatic colorectal cancer and extend survival for patients. The use of Cyramza is associated with a risk of severe bleeding and hypertension, among other side effects, and its use should be carefully considered in the context of these risks. Despite these concerns, Cyramza remains an important treatment option for patients with advanced colorectal cancer, particularly those who have limited alternatives due to the progression of their disease after first-line therapy.